Suturing methods and apparatuses

Abstract

Suturing devices, systems, and methods used to suture biological structures. The suturing devices can be configured to place sutures into body tissue from one side of the tissue without requiring a component on an opposite side of the tissue and without requiring insertion of components into the body tissue beyond the needles and the suture.

What is claimed is: 
     
       1. A method of applying suture to an internal biological structure, the method comprising:
 delivering a distal facing surface at a distal tip of a suturing device to a position within a patient and against a section of tissue of the internal biological structure; 
 advancing a needle from the distal facing surface into the section of tissue in a first direction; 
 advancing the needle in a second direction different from the first direction and into engagement with a suture portion; 
 retracting the needle back through the section of tissue to draw the suture portion through the section of tissue; and 
 withdrawing the distal facing surface of the suturing device from the position against the section of tissue to be sutured; 
 further comprising advancing a sheath distal to the suturing device to separate the distal facing surface of the suturing device from the section of tissue. 
 
     
     
       2. The method of applying suture to an internal biological structure of  claim 1 , wherein the needle is advanced into the section of tissue from a first side of the tissue and the needle passes out of the section of tissue through the first side of the tissue before engaging with the suture portion. 
     
     
       3. The method of applying suture to an internal biological structure of  claim 1 , wherein advancing the needle in the first direction and advancing the needle in the second direction is a continuous advancement. 
     
     
       4. The method of applying suture to an internal biological structure of  claim 1 , wherein advancing the needle comprises rotating the needle. 
     
     
       5. The method of applying suture to an internal biological structure of  claim 1 , wherein advancing the needle into the section of tissue comprises advancing the needle from a retracted position within the suturing device through the distal facing surface of the suturing device. 
     
     
       6. A method of suturing an internal body lumen, the method comprising:
 delivering a distal facing surface at a distal tip of a first suturing device into the body lumen; 
 aligning the distal facing surface at the distal tip of the first suturing device with an inner wall of the body lumen against a first entry location; 
 advancing a needle of the first suturing device from the distal facing surface through the inner wall in a first direction at the first entry location; 
 advancing the needle of the first suturing device in a second direction different from the first direction and into engagement with a first suture portion; 
 retracting the needle of the first suturing device back through the first entry location to draw the first suture portion through the inner wall; 
 withdrawing the distal tip of the first suturing device from alignment with the inner wall at the first entry location; 
 aligning a distal facing surface at a distal tip of a second suturing device with the inner wall of the body lumen against a second entry location on an opposite side of the body lumen as the first entry location; 
 advancing a needle of the second suturing device from the distal facing surface of the second suturing device through the inner wall in a third direction at the second entry location; 
 advancing the needle of the second suturing device in a fourth direction different from the third direction and into engagement with a second suture portion; 
 retracting the needle of the second suturing device back through the second entry location to draw the second suture portion through the inner wall; 
 withdrawing the distal tip of the second suturing device from alignment with the inner wall at the second entry location; and 
 drawing the first suture portion through the inner wall closer to the second suture portion through the inner wall to thereby tighten the body lumen. 
 
     
     
       7. The method of suturing an internal body lumen of  claim 6 , wherein the first suturing device and the second suturing device are the same suturing device. 
     
     
       8. The method of suturing an internal body lumen of  claim 6 , wherein the first suture portion is joined with the second suture portion before the first suture portion through the inner wall is drawn closer to the second suture portion through the inner wall. 
     
     
       9. The method of suturing an internal body lumen of  claim 6 , further comprising withdrawing the first suturing device prior to aligning the distal facing surface at the distal tip of the second suturing device. 
     
     
       10. The method of suturing an internal body lumen of  claim 6 , wherein the first suture portion is within the body lumen when the needle of the first suturing device engages the first suture portion. 
     
     
       11. The method of suturing an internal body lumen of  claim 6 , further comprising advancing the needle of the first suturing device through the inner wall and into the body lumen at a first exit location different from the first entry location.